The Clinicopathology, Treatment Pattern and Survival of Nasopharyngeal Carcinoma Patients at Tikur Anbessa Specialized Hospital, Oncology Department, Addis Ababa, Ethiopia.
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Date
2021-04
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Addis Ababa University
Abstract
Background: Nasopharyngeal carcinoma is one of the most common head and neck cancers worldwide and its incidence is reported to be increasing both in developed and developing countries. There is, however, lack of published data on nasopharyngeal carcinoma in Ethiopia.
Objective: To assess the clinicopathology, treatment patterns and median survival of patients diagnosed with nasopharyngeal carcinoma at Tikur Anbessa Specialized Hospital (TASH), Oncology Department, Ethiopia
Methodology: A retrospective cohort study design of histopathologic proven nasopharyngeal carcinoma patients seen at the Oncology Department of TASH from September 11, 2014 and September 10, 2017 and followed for vital status up until October 2020. Descriptive statistics (mean, SD, frequency, percentage) were calculated and chi-square tests were performed using SPSS version 26, with P<05 for level of statistical significance. Survival curves were analyzed using the Kaplan-Meier method, and survival curves between groups of patients were compared using a log-rank test. A multivariable Cox proportional hazard model was used to identify prognostic factors.
Results: A total of 170 patients with histopathological confirmed nasopharyngeal cancer were seen in the Oncology Department during the study period. The mean age of the patients was 37.73 ±17.7 SD years, with 2:1 male to female ratio. Majority 77 (56.6%) of the histology types were taken from Lymphnode with 36 (26.5%) showing secondary carcinoma from nasopharynx. Generally 113 (83.31%) of the patients presented with stage III-IV. 23.5 % of the patients did not take any form of treatment. Of those who received treatment, the most common form of treatment was induction chemotherapy (19.1%), followed by concurrent chemo radiotherapy (16.9%). Patients had to wait on average 3.24 months to get any types of treatment. The median waiting periods were 8.4 months for any form of radiation and 3.3 months for chemotherapy. The median followup period was 23.3 months, and the median survival was 33 months. Survival was statistically significantly associated with advancing age, keratinizing histologic type, lack of receipt of treatment, suboptimal dose of RT and nodal disease. However, Sex, Tumor stage, metastasis, group stage, waiting time to treatment and performance status were not significantly affecting the survival time of patients.
Conclusion: Majority of patients with nasopharyngeal cancer seen at TASH in Addis Ababa are presented at advanced stage of the disease, and with exceedingly long waiting period for receipt of radiotherapy and poor survival outcomes. These findings underscore the need for development of public health plans for early diagnosis and treatment of nasopharyngeal cancer and for expansion of radiotherapy services in the country.
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Nasopharyngeal carcinoma patients,Clinicopathology